{
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"FirstLineMailingAddress": "719 STARLIGHT PASS",
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"MailingAddressCityName": "HEATH",
"MailingAddressStateName": "TX",
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"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "362 OAKS TRL STE 142",
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"PracticeLocationAddressCityName": "GARLAND",
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"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/04/2018",
"LastUpdateDate": "12/04/2018",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PARKER",
"AuthorizedOfficialFirstName": "KEVIN",
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"AuthorizedOfficialCredential": "DC",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
"LicenseNumber": null,
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}